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4 November 2005 The Shocking Connection Between Obesity And Cancer
by Katherine Burnett-Watson
Recent statistical data exploring the relationship between obesity and cancer has shown that an alarming 10 percent of all cancers are obesity-related. In the USA today, over 100,000 cases of cancer are directly related to patients being overweight or obese. Dr Colditz, from the Harvard School of Public Health, released these figures at a recent press conference during the American Association for Cancer Research's international conference on Frontiers in Cancer Prevention Research.
Dr Colditz elaborated on these figures by stating the percentages and numbers of individual types of cancer that would be avoided if no-one were overweight or obese. (See table below)
| Type of Cancer | % Related to Obesity | Cases this % Equals |
| Colon Cancer | 14 percent | Not Supplied |
| Breast Cancer | 11 percent | Over 18,000 |
| Endometrial (Uterine) | 49 percent | 20,000 |
| Kidney Cancer | 31 percent | Over 11,000 |
| Esophageal Cancer | 39 percent | 5,500 |
| Pancreatic Cancer | 14 percent | 4,500 |
| Non-Hodgkin Lymphoma | 20 percent | Over 11,0000 |
The figures, derived from a review of published studies, reinforce the message that overweight and obese individuals are more likely to develop cancer, as well as other chronic diseases such as diabetes, heart disease, and stroke. "We can clearly conclude that adult overweight and obesity cause cancer and increasing rates of obesity in the US are continuing to drive up the burden of these cancers," Dr Colditz said.
The biological mechanism that explains how obesity increases cancer risk may be different for different cancers. Possible mechanisms include alterations in sex hormones (e.g., estrogen, progesterone, and androgens), and insulin and insulin-like growth factor 1 (IGF-1) in obese people that may account for their increased risk for cancers of the breast, endometrium (uterine), and colon.
Since the late 1980s, adult obesity has steadily increased in the USA. Today, about 64 percent of Americans are overweight and more than 30 percent are obese.
In March 2004, the Food and Drug Administration (FDA) released a report from its Obesity Working Group to tackle what it calls the “nation’s obesity epidemic”. The group's long- and short-term proposals are based on the scientific fact that weight control is mainly a function of caloric balance; that is, calories in must equal calories out. The FDA has focused on "calories count" as the basis of its actions and the message of its obesity campaign.
Along with the FDA, the US Department of Health and Human Services (HHS) has identified that poor diet and a sedentary lifestyle are the main factors contributing to overweight and obesity, and that counting calories is critical for people trying to achieve and maintain a healthy weight. But how easy is it to decipher the “Nutritional Facts” panel on food packaging, and what exactly do phrases like “light”, “low fat” and “reduced calorie” mean?
The recent interest in low-carbohydrate diets and products has led to some manufacturers labeling their products as “low in carbohydrates”, “reduced carbohydrates” or some variation of this. At the moment, the FDA has no set definition for what constitutes a low carbohydrate food, and so the amount of carbohydrates may vary greatly between products claiming to be “low carb”. Similarly, the “low fat” option may not be the low-calorie option, as low fat foods may have a lot of sugar, and are therefore high in calories.
The FDA has strict definitions when it comes to labeling foods in reference to their sugar, fat, calorie and cholesterol content:
- low-fat: 3 g or less per serving.
- low-saturated fat: 1 g or less per serving.
- low-sodium: 140 mg or less per serving.
- very low sodium: 35 mg or less per serving.
- low-cholesterol: 20 mg or less and 2 g or less of saturated fat per serving.
- low-calorie: 40 calories or less per serving.
- low-sugar/no-sugar: less than 0.5 g per serving.
Products labeled as having these qualities must adhere to the FDA’s definitions: a product that claims to be “low fat” must contain 3g of fat or less per serving.
Although a great many measures are being taken by government, private companies and scientific research to curb obesity, the buck (or burger) really stops with the consumer. So what measures can we as individuals take to maintain a healthy weight and lifestyle, and thereby reduce our risk of weight-related cancers and chronic diseases?
Determining whether you are overweight or obese is the first step. Overweight or obese is no longer just about the numbers on the bathroom scale. A better way to measure obesity is by using the formula known as the Body Mass Index, or BMI, which measures the ratio between weight and height.
To determine your BMI in inches and pounds, multiply your weight in pounds by 703. Then multiply your height in inches by your height in inches again. The final step is to divide your weight equation by your height equation.
For example, if you were 5ft 6 inches, or 66 inches tall, and you weighed 150 pounds, your equation would look like this:
Weight equation - 150 x 703 = 105,450
Height equation – 66 x 66 = 4356
BMI – 105,450 / 4356 = 24.2
Understanding your BMI Results
| Less than 18.5 | Underweight |
| 18.5 – 24.9 | Healthy Body Weight |
| 25 – 29.9 | Overweight |
| 30 or above | Obese |
So in this instance, the individual in the equation above would fall in the category of Healthy Body Weight.
Although the BMI is a better indicator of healthy body weight that just your weight alone, it still doesn’t take into account your body shape and type. For example the BMI doesn’t take into account whether you are fine-boned or heavy-boned. A muscular person may measure as overweight on the BMI because muscle weighs more than fat.
This is why it is recommended that you also take into account your waist circumference. A waist circumference of over 35 inches in women, and over 40 inches in men, combined with a BMI of 25 or above, would indicate the individual is overweight.
To correctly measure your waist circumference, locate your upper hip bone and place a measuring tape around your abdomen (ensuring that the tape measure is horizontal). The tape measure should be snug but should not cause compressions on the skin.
If, from these calculations, you determine you are overweight or obese, to reduce your chances of developing obesity-related cancer or chronic disease you need to develop a strategy to lower your BMI and waist circumference.
"Counting calories is critical for people trying to achieve and maintain a healthy weight," HHS Secretary Tommy G. Thompson said. "[The] FDA's overall strategy [gives] consumers accurate, helpful information that allows them to make wise food choices at home, at supermarkets and in restaurants. Taking small steps to eat a more balanced diet and to stay physically active can go a long way to reversing the epidemic of obesity that harms far too many Americans."
In their publication Dietary Guidelines for Americans 2005, the FDA makes the following suggestions for creating and maintaining a healthy lifestyle, and to reduce the chance of obesity-related illness and disease.
Weight management
- To maintain body weight in a healthy range, balance calories from foods and beverages with calories expended.
- To prevent gradual weight gain over time, make small decreases in food and beverage calories and increase physical activity.
Physical activity
- Engage in regular physical activity and reduce sedentary activities to promote health, psychological well-being, and a healthy body weight.
- To reduce the risk of chronic disease in adulthood: Engage in at least 30 minutes of moderate-intensity physical activity, above usual activity, at work or home on most days of the week.
- To help manage body weight and prevent gradual, unhealthy body weight gain in adulthood: Engage in approximately 60 minutes of moderate- to vigorous-intensity activity on most days of the week while not exceeding caloric intake requirements.
- To sustain weight loss in adulthood: Participate in at least 60 to 90 minutes of daily moderate-intensity physical activity while not exceeding caloric intake requirements. Some people may need to consult with a healthcare provider before participating in this level of activity.
- Achieve physical fitness by including cardiovascular conditioning, stretching exercises for flexibility, and resistance exercises or calisthenics for muscle strength and endurance.
Food groups to encourage
- Consume a sufficient amount of fruits and vegetables while staying within energy needs. Two cups of fruit and 2.5 cups of vegetables per day are recommended for a reference 2,000-calorie intake, with higher or lower amounts depending on the calorie level.
- Choose a variety of fruits and vegetables each day. In particular, select from all five vegetable subgroups (dark green, orange, legumes, starchy vegetables, and other vegetables) several times a week.
- Consume 3 or more ounce-equivalents of whole-grain products per day, with the rest of the recommended grains coming from enriched or whole-grain products. In general, at least half the grains should come from whole grains.
- Consume 3 cups per day of fat-free or low-fat milk, or equivalent milk products.
Fats
- Consume less than 10 percent of calories from saturated fatty acids and less than 300 mg/day of cholesterol, and keep trans fatty acid consumption as low as possible.
- Keep total fat intake between 20 to 35 percent of calories, with most fats coming from sources of polyunsaturated and monounsaturated fatty acids, such as fish, nuts, and vegetable oils.
- When selecting and preparing meat, poultry, dry beans, and milk or milk products, make choices that are lean, low-fat, or fat-free.
- Limit intake of fats and oils high in saturated and/or trans fatty acids, and choose products low in such fats and oils.
Carbohydrates
- Choose fiber-rich fruits, vegetables, and whole grains often.
- Choose and prepare foods and beverages with little added sugar or caloric sweeteners, such as amounts suggested by the USDA Food Guide and the DASH Eating Plan.
- Reduce the incidence of dental caries by practicing good oral hygiene and consuming sugar- and starch-containing foods and beverages less frequently.
For more information on obesity-related cancers and chronic diseases, and guidelines on living well through a healthy diet and exercise, visit the FDA’s web site www.fda.gov or the Department of Health and Human Services www.hhs.gov.
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